Medicine and Health Sciences Commons^™

Blind Nasal Intubation As A Rescue Strategy In Difficult Airway Management, Riaz Chowdhury, Ashalatha K. Nair, Dheeraj Kamalam, Rohit Jaishankar

HCA Healthcare Journal of Medicine

Background

Airway management in emergency situations poses significant challenges, particularly in patients with difficult airway anatomy or comorbid conditions. Blind nasal intubation has been explored as a rescue technique when conventional methods fail. Masseter muscle rigidity (MMR), characterized by significant jaw muscle stiffness, is a recognized complication following succinylcholine administration that can complicate traditional approaches to securing an airway.

Case Presentation

A 75-year-old man with multiple comorbidities, including hypertension, prior stroke with paralysis, dementia, and a seizure disorder, presented with acute hypercapnic hypoxemic respiratory failure requiring emergent intubation. Orotracheal intubation failed due to trismus despite etomidate, succinylcholine, and rocuronium. Nasal …

Sustained Supraventricular Tachycardia While In Active Phase Labor, Austin Gold, Mona Sadek

HCA Healthcare Journal of Medicine

Background

Supraventricular tachycardia (SVT) is one of the most common tachyarrhythmias found in young women, and SVT can be exacerbated by pregnancy. The symptoms associated with SVT frequently overlap with physiologic changes and symptoms of pregnancy which can lead to delayed or missed diagnosis.

Case Presentation

We describe the presentation and the acute management of a patient who had sustained SVT that developed during the active phase of labor. We then detail the varying management approaches of SVT in pregnancy and labor as well as refractory management options. Maternal monitoring will also be discussed as this case shows how an …

The “Wearing Off” Phenomenon For Rasagiline, Entacapone, Carbidopa, And Levodopa In The Setting Of Parkinson’S Disease, Ryan Cromwell, Tevin Um

HCA Healthcare Journal of Medicine

Background

Parkinson’s disease is a primary neurological dysfunction syndrome in which the body’s natural production of dopamine is reduced. Therapeutic intervention for this disease primarily includes medications that increase the body’s natural production of dopamine. These medications can have side effects, requiring constant titration based on the patient’s symptoms.

Case Presentation

We report a case study of a 75-year-old man diagnosed with Parkinson’s disease who had a profound acute exacerbation of psychological symptoms following modifications to his dopaminergic treatment regimen. Initially, the patient was prescribed carbidopa/levodopa, rasagiline, and carbidopa/levodopa/entacapone. However, the treatment plan was adjusted due to the worsening of …

An Unusual Presentation Of Subcutaneous Inguinal Hematoma Mimicking Ovarian Torsion: A Case Report, Chrystal Stallworth, Timothy Kremer, Victoria Panzanaro

HCA Healthcare Journal of Medicine

Background

Ovarian or adnexal torsions occur when an ovary rotates around one of the supporting ligaments, often the infundibulopelvic (IP) ligament. This rotation can cause the blood flow to the ovary to be hindered, and this decrease in perfusion can often present as adnexal pain, nausea, and vomiting. A significant risk factor for developing an ovarian torsion is the presence of an ovarian mass, such as a cyst. The diagnosis of ovarian torsion is a medical emergency, but symptoms typically resolve with prompt surgical intervention. Hematomas occurring within or around the inguinal region have been reported to occur primarily after …

Risk Factors Associated With Worse Outcomes In Trauma Patients Aged 55 And Older, Hector Mendez, Ilko Luque, Nicole Yordán López, Carlos Parra, Kelvin Chan, Mariel A. Javier, Marcela Ramirez, Orlando Morejón

HCA Healthcare Journal of Medicine

Background

Prior studies have shown an increase in mortality in trauma patients after 55 years of age. However, it is less certain which pre-existing comorbidities (PECs) are associated with poorer outcomes. The purpose of this study was to identify the risk factors associated with poor outcomes and death in patients 55 years old and older admitted for trauma.

Methods

Trauma patients (age ≥ 55) were studied retrospectively from the local trauma registry at HCA Florida Kendall Hospital, a level 1 trauma center (2020–22). We collected the subject’s age, gender, PECs, and outcome data. Then we performed multiple logistic regression to …

Updating A Rural Clinic In Tiburón, Haiti, Akankcha Alok, Mohamed Bakhit, Djenie Helne, Philipe Milord, Marcellas Socrate, Camil Clermont, Marie A. Kima

HCA Healthcare Journal of Medicine

Background

Tiburón is a small fishing village in Haiti with a clinic overseen by the Oblate missionaries and the Ministry of Public Health and Population (MSPP). This village was hugely impacted by Hurricane Matthew in 2016, leading to increased health care demands. The clinic was inaccessible from the furthest parts of the village and lacked basic medication supplies and adequate manpower. We aimed to reinforce the infrastructure and update the clinic using a multifaceted approach.

Methods

We developed a quality improvement project to strengthen the clinic's infrastructure and modernize its facilities with a comprehensive approach focused on enhancing health care …

Synthetic Versus Biologic Mesh For Complex Open Ventral Hernia Repair: Three-Year Follow-Up Of A Pilot Randomized Controlled Trial, Nalia H. Dhanani, Nicole B. Lyons, Kyung Hyun Lee, Oscar A. Olavaarria, Aris R. Arakelians, Julie L. Holihan, Lillian S. Kao, Ali Siddiqui, Connor Hogan, Tunmi Anwoju, Zuhair Ali, Mike K. Liang

HCA Healthcare Journal of Medicine

Background

Biologic mesh is often used in complex hernia repair, but there has been limited clinical evidence to date to support this practice. The aim of this study was to compare clinical and patient-reported outcomes of biologic versus synthetic mesh for complex open ventral hernia repair (OVHR) at 3 years.

Methods

Patients from a single center, randomized, controlled, pilot trial comparing biologic versus synthetic mesh in complex OVHR were followed for 3 years. The primary outcome focused on major complications, namely mesh infections, hernia recurrences, reoperations, and deaths. Secondary outcomes included surgical site infections, surgical site occurrences, and patient-reported outcomes. …

Impact Of A Comprehensive Palliative Quality Improvement Initiative (Icu-Pal) In A Medical-Surgical Intensive Care Unit, Aunie M. Danyalian, Michele M. Iguina, Manjot Malhi, Umair Shaikh, Sanaz B. Kashan, Dionne Morgan, Daniel Heller, Mauricio Danckers

HCA Healthcare Journal of Medicine

Background

Early palliative care practice implementation in the intensive care unit (ICU) improves advance care planning, promotes patient and family satisfaction, and decreases health care costs. The consensus for protocolized palliative care delivery is unknown. We assessed the impact of a qualitive improvement educational intervention that promotes the identification of critically ill patients who will benefit from early expert palliative care interventions.

Methods

In this observational study, we examined the impact of an educational intervention that promoted (1) early detection of palliative care triggers (PCT) during ICU multidisciplinary rounds (MDRs), (2) admission and 48-hour pain assessment, and (3) family meetings …

A New Paradigm In Hospital Medicine: Evaluating The Effects Of Geographical Cohorting On Health Care Delivery, Vasu Gupta, Bhupinder Singh, Kanishk Aggarwal, Ayushi Garg, Rhea Kanwar, Fnu Anamika, Inder Preet Kaur, Rohit Jain

HCA Healthcare Journal of Medicine

Background

Geographical cohorting in hospital settings represents a significant shift from traditional patient rounding practices and aims to enhance the efficiency of health care delivery. This model assigns hospitalists to a particular inpatient unit, where most of their patients are located. While this model has several benefits, including streamlining health care procedures, optimizing resource allocation, and fostering better provider communication, its implementation is not without its challenges.

Methods

Our methodology for researching geographical cohorting involved a comprehensive literature review of peer-reviewed studies, surveys, and retrospective analyses. We utilized academic databases, such as PubMed, JSTOR, and Google Scholar, to identify relevant …

Acute Exacerbation Of Idiopathic Pulmonary Fibrosis In The Setting Of Acute Eosinophilic Pneumonia, Duncan A. Mckinney, Noah R. Kosnik, Shahzeib Syed, Gretchen Junko

HCA Healthcare Journal of Medicine

Idiopathic pulmonary fibrosis (IPF) is a progressive disease characterized by gradual destruction and replacement of pulmonary parenchyma with fibrous tissue, which occurs in conjunction with chronic inflammation. It is often considered a prototypical interstitial lung disease and is both the most prevalent and perhaps the most dangerous in that family. Although the disease is uncommon in the general population, its prevalence increases with age and is typically diagnosed around the age of 65. This does not preclude the development of IPF in younger individuals, and the mean survival is 2 to 5 years post-diagnosis regardless of age. Contemporary studies have …

Extended-Release Buprenorphine Could Overcome Barriers To Medical Treatment Of Opioid Use Disorder In At-Risk Populations, Scott A. Davis, Genevieve Verrastro, E Blake Fagan

HCA Healthcare Journal of Medicine

This article discusses how monthly extended-release buprenorphine can be used to improve the treatment of opioid use disorder (OUD). In particular, the use of monthly extended-release buprenorphine holds promise for patients who have recently been released from jail or prison and are battling OUD, those who are unstable and continue to use opioids illicitly, patients who are experiencing homelessness while also struggling with OUD, and those who are stable and want to be weaned off buprenorphine.

An Acknowledgement To The Hca Healthcare Journal Of Medicine's Reviewers And Editors For The 2nd Half Of 2024, Juan A. Sanchez, Graig Donini

HCA Healthcare Journal of Medicine

The HCA Healthcare Journal of Medicine would like to thank those behind the scenes who make this publication possible. Our journal would not be possible without the assistance of our peer reviewers, authors, and board members.

A New Chapter For The Hca Healthcare Journal Of Medicine: Elevating Our Impact And Vision, Juan A. Sanchez

HCA Healthcare Journal of Medicine

Dr Juan A Sanchez, the new editor-in-chief of the HCA Healthcare Journal of Medicine, shares his vision for elevating the journal's influence by publishing high-quality, impactful research. Moving forward, the journal will introduce new initiatives, including more special issues and invited editorial commentaries, to foster a dynamic academic environment. Dr Sanchez invites the medical community to contribute and engage with the journal to advance medical knowledge and improve health care outcomes.

A Case Of Injury-Induced Pyoderma Gangrenosum Requiring Skin Graft, Yukiko Brewer, Nameer Ascandar, Tesnim Hamdan, Iryna Witt, Sana Khan, Robert Cropper

West Florida Division GME Research Day 2025

No abstract provided.

Emphysematous Cystitis In A 60-Year-Old Female Who Had Reported No Medical Care For Decades, Taylor O'Brien, Scott Scher, Brian Wexler, Daniel Breznau, Karen Joseph

West Florida Division GME Research Day 2025

No abstract provided.

Superior Vena Cava Syndrome Masquerading As Angioedema: A Chemotherapy Port Complication, Vishal Shah, Philip Mardock, Austin Patrick-Eisenberg, Thaddeus Golden

South Atlantic Division GME Research Day 2025

No abstract provided.

Covid-19 Induced Mda5-Associated Necrotizing Myositis, Sarah Steadman, Amit Sikder, Harsh R. Desai, Bradley Collins, Tiffany Baker, Julie Worthington

South Atlantic Division GME Research Day 2025

No abstract provided.

Factors Associated With Std Hospital Admissions In South Carolina Hospitals (2020-2024), Darrell Holmes, Dennis Besong

South Atlantic Division GME Research Day 2025

No abstract provided.

Appendicular Band Syndrome As A Cause Of Infantile Small Bowel Obstruction, Brandon M. Epps, Alexis Smith

South Atlantic Division GME Research Day 2025

No abstract provided.

Co-Occurrence Of Autoimmune Hepatitis And Pheochromocytoma: A Complex Diagnostic And Treatment Challenge, Himani Patel, Gabrielle Aiello, Taylor Frazier, Sage Havrilla, Payton Williams, Meghan Rosenquist

South Atlantic Division GME Research Day 2025

No abstract provided.

From Lost Balance To Leaky Chyle: A Case Report Of Traumatic Chylothorax, Taylor Johnson, Glenn Carlos

South Atlantic Division GME Research Day 2025

No abstract provided.

Intraumbilical Mass With Cyclical Drainage, Alexis Coican, Angelia Stepien, Laszlo Karai

South Atlantic Division GME Research Day 2025

No abstract provided.

Improving Antibiotic Decision Making Amongst Medical Residents, Andrew Baird, Mina Guirguis, Brian Steiner, Daniel Khashchuk

South Atlantic Division GME Research Day 2025

No abstract provided.

Hook, Line And Lid: Managing A Fishhook Injury To The Eye, Daniel Tate, Lisa Persaud, Jonathan Leggett

South Atlantic Division GME Research Day 2025

No abstract provided.

Extrinsic Motivation Enhances Clinical Ultrasound Utilization Amongst Residents, Bailey Spencer, Steven Rickett, Jacob Pope, Sanna Ho-Gotshall, Casey Wilson

South Atlantic Division GME Research Day 2025

No abstract provided.

Prophylactic Resuscitative Endovascular Balloon Occlusion In The Management Of Placenta Percreta: A Case Report, Monica Rodriguez, Nicole Tenzel, Rachel Russo, Robert Cohen

North Texas Research Forum 2025

Introduction: Placenta accreta spectrum disorders (PASD) are associated with severe maternal morbidity, including hemorrhage requiring massive transfusion, intensive care unit (ICU) admission, coagulopathy, organ ischemia or failure, and death. The adherent placenta results in continuous mixed arterial and venous bleeding, preventing the uterus from adequately contracting. This can result in a blood loss rate of 600 mL or more per minute, posing a risk of exsanguination in less than five minutes. Few reports exist on the prophylactic use of resuscitative endovascular balloon occlusion of the aorta (REBOA) to reduce obstetric hemorrhage and its application for prolonged occlusion times exceeding 60 …

Levothyroxine And Drug-Induced Lupus Erythematosus: A Retrospective Cohort Study, Tue Nguyen, Yousef Salem, Aqsa Kanwal, Aeja Weiss

Gulf Coast Division GME Research Day 2025

No abstract provided.

Approach To Documenting Weight Loss Efforts And Lifestyle Modifications Within Hca Florida Oak Hill Family Care, Daisy Gandhi, Jenna Latona, Cheyenne Pirrello, Taylor Butts

West Florida Division GME Research Day 2025

No abstract provided.

Spontaneous Choledochoduodenal Fistula Post-Cholecystectomy: Successful Endoscopic Management Of A Rare Complication Using Cholangioscopy And Lithotripsy, Fernando Lugo-Hernandez, Omar Jureyda, Viraj Modi, Bhavtosh Dedania

West Florida Division GME Research Day 2025

No abstract provided.

Disseminated Mycobacterium Marinum Presenting As Bursitis In A Patient With Psoriatic Arthritis On Adalimumab, Mallory Suhling, Aditya Dutt, Olivia Cook, Summer Moon

West Florida Division GME Research Day 2025

No abstract provided.